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1. A
2. Skip
3. C
Pembahasan :

endothoracica = a. mammaria interna. It divides into two terminal branches: Superior

epigastric artery, Musculophrenic artery

4. A
5. E
Pembahasan : Pseudohyperkalemia has been defined as a marked increase of in vitro serum
potassium levels in the absence of clinical evidence of electrolyte imbalance. So while true
hyperkalemia is a potentially life-threatening clinical condition needing immediate medical
intervention, pseudohyperkalemia exhibits no toxic affects because the increased potassium
values does not reflect the actual in vivo potassium levels. However, pseudohyperkalemia
can be quite misleading, and when overlooked could lead to inappropriate treatment and
potentially detrimental therapy.

So what are some causative factors of pseudohyperkalemia? The list is quite extensive.
Variables include collection technique such as fist clenching, mechanical trauma during or
after phlebotomy, potassium contamination (i.e. carry over from K+-EDTA or
oxalate/fluoride tubes), refrigeration before centrifugation, delay in centrifugation,
decreased transport or storage temperature, pneumatic tube transport, hemolysis and
clotting. Clinical conditions of leukocytosis (i.e. chronic lymphocytic leukemia, infectious
mononucleosis), thrombocytosis (i.e. myeloproliferative disorders), abnormal erythrocyte
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morphology (i.e. familial pseudohyperkalemia), renal disease and rheumatoid arthritis have
all exhibited factitious hyperkalemia at one time or another. Additionally, there is reverse
pseudohyperkalemia - pseudohyperkalemia with a twist where in increased potassium levels
are detectable in plasma while serum samples are within normal range. Here the interaction
of heparin with cell membranes is thought to be the culprit.
19:52 Khairunnisa N Huda jadi pseudohiperkalemia itu biasanya karena potasium yg keluar
dari platelet ketika terjadi agregasi platelet dan degranulasi
19:52 Khairunnisa N Huda nah terus biasanya juga bisa akibat mechnical trauma after
phlebotomy
19:53 Khairunnisa N Huda trus kusimulkan salah satu mechanical trauma adalah penggunaan
jarum yg besar saat phlebotomy
6. B
Pembahasan :
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7. D
Pembahasan :
setelah pemberian diuretika harus dilakukan pemeriksaan K, glukosa dan lipid. karena e.s
dari diuretik bisa hipokalemi,dizzy, hiperlipid, hiperglikek dan gout.
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8. C
9. C
Pembahasan :
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10. A
11. C
Pembahasan :

12. C (handout)
13. B
Pembahasan :

14. C
Pembahasan :
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15. A (slide histo)

16. D (tunika media kan isinya otot polos, aneurisma dilatasi arteri)
17. Skip
18. B -> hambat reabsorbsi nacl di TK distal hul
19. C -> Ada edem tungkai--kasih diuretik
20. A
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Kalo q wave udah kronik. Kalo iskemi st depresi sm perub gel t. Q patologis itu infsrk
21. E
Pembahasan :
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Harusnya hdl meningkatkan arus balik

22. B
23. B
Pembahasan :
Bising ejeksi sistolik (ejection systolic)
Timbul akibat aliran darah yang dipompakan melalui bagian yang menyempit dan mengisis
sebagian fase sistolik. Misalnya pada stenosis aorta, dimana bising tersebut mempunyai
punctum maximum di daerah aorta dan mungkin menjalar ke apeks kordis. Bising dimulai
setelah bunyi jantung I, bersifat kresendo-dekresendo, dan berhenti sebelum bunyi jantung
II; bising ini terdapat pada bising inosen, bising fungsional, stenosis pulmonal atau stenosis
aorta, defek septum atrium, atau tetralogi fallot.
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24. E (slide PJB)

Pembahasan :
congenital heart defect where the aorta is positioned directly over a ventricular septal
defect (VSD)

25. A
26. A
Pembahasan :

27. E
Pembahasan :
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28. D
Pembahasan :
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29. B
30. B
Pembahasan :
A sistol
D sistol
diastolik -> pas lg ngisi ventrikel ada bising -> berarti ada stenosis di mitral
krn di apeks -> mitral
31. C
32. E
Pembahasan :
a. Squatting: bahasa: berjongkok; Squatting occurs in children with certain congenital heart
disease. Typically, the child will interrupt his/her play and squat for a few seconds, then
resume play. (http://heartdisease.about.com/library/symptoms/blsysquatting.htm)
b. Orthopnea: Orthopnea is an early symptom of heart failure and may be defined as
dyspnea that develops in the recumbent position and is relieved with elevation of the head
with pillows. (medscape)
c. Hypoxic spell: The 'Tet spell' (also called 'hypoxic spell', 'cyanotic spell', 'hypercyanotic
spell', 'paroxysmal dyspnea') is an episodic central cyanosis due to total occlusion of right
ventricle outflow in a patient with a congenital heart disease, such as Tetralogy of Fallot
(TOF). Hypercyanotic spell characterized by paroxysm of hyperpnea (rapid and deep
respirations),irritability and prolonged cry, increased cyanosis and decreased intensity of
heart murmur.
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d. Dyspnea effort: Dyspnea D’effort yaitu sesak nafas yang terjadi saat melakukan kegiatan
fisik dan akan menghilang bila beristirahat beberapa saat.
(http://kolomkesehatan.net/gejala-penyakit-jantung/)
e. PND: Paroxysmal nocturnal dyspnea usually occurs at night and is defined as the sudden
awakening of the patient, after a couple of hours of sleep, with a feeling of severe anxiety,
breathlessness, and suffocation. (medscape)

33. E
Pembahasan :

34. A/D (alkohol -> dilatasi)

35. A
36. C/D (nadia catet kardiomiopati kok eko ya)
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37. A/C
38. E
39. D
Pembahasan :

40. B
Pembahasan :

fase 4: Na dikit, 0: Na, 1: K, 2: Ca, 3: K